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Open Access 01-03-2020 | Myocardial Infarction | Original Paper

Predictors of transportation delay in patients with suspected ST-elevation-myocardial infarction in the VIENNA-STEMI network

Authors: Bernhard Jäger, Paul Michael Haller, Edita Piackova, Alfred Kaff, Günter Christ, Wolfgang Schreiber, Franz Weidinger, Thomas Stefenelli, Georg Delle-Karth, Gerhard Maurer, Kurt Huber, for the Vienna STEMI Registry Group

Published in: Clinical Research in Cardiology | Issue 3/2020

Abstract

Objective

The emergency medical service (EMS) provides rapid pre-hospital diagnosis and transportation in ST-elevation myocardial infarction (STEMI) systems of care. Aim of the study was to assess temporal and regional characteristics of EMS-related delays in a metropolitan STEMI network.

Methods

Patient call-to-arrival of EMS at site (call-to-site), transportation time from site to hospital (site-to-door), call-to-door, patient’s location, month, weekday, and hour of EMS activation were recorded in 4751 patients referred to a tertiary center with suspicion of STEMI.

Results

Median call-to-site, site-to-door, and call-to-door times were 9 (7–12), 39 (31–48), and 49 (41–59) minutes, respectively. The shortest transportation times were noted between 08:00 and 16:00 and in general on Sundays. They were significantly prolonged between midnight and 04:00, whereby the longest difference did not exceed 4 min in median. Patient’s site of call had a major impact on transportation times, which were shorter in Central and Western districts as compared to Southern and Eastern districts of Vienna (p < 0.001 between-group difference for call-to-site, site-to-door, and call-to-door). After multivariable adjustment, patient’s site of call was an independent predictor of call-to-site delay (p < 0.001). Moreover, age and hour of EMS activation were the strongest predictors of call-to-site, site-to-door, and call-to-door delays (p < 0.05).

Conclusion

In our Viennese STEMI network, the strongest determinants of pre-hospital EMS-related transportation delays were patient’s site of call, patient’s age, and hour of EMS activation. Due to the significant but small median time delays, which are within the guideline-recommended time intervals, no impact on clinical outcome can be expected.

Graphic abstract

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Title: Predictors of transportation delay in patients with suspected ST-elevation-myocardial infarction in the VIENNA-STEMI network
Authors: Bernhard Jäger
Paul Michael Haller
Edita Piackova
Alfred Kaff
Günter Christ
Wolfgang Schreiber
Franz Weidinger
Thomas Stefenelli
Georg Delle-Karth
Gerhard Maurer
Kurt Huber
for the Vienna STEMI Registry Group
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keyword: Myocardial Infarction
Published in: Clinical Research in Cardiology / Issue 3/2020
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-019-01520-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors of transportation delay in patients with suspected ST-elevation-myocardial infarction in the VIENNA-STEMI network

Abstract

Objective

Methods

Results

Conclusion

Graphic abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Graphic abstract

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